Individual provider Active NPI

Courtney Mariko Kahealani Kim

  • Emergency Medicine Physician
  • Honolulu, HI
National Provider Identifier
1871241885
Registry record updated Aug 18, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
MD-26808-0 Issued in HI
Practice address
770 Kapiolani Blvd Ste 705
Honolulu, HI 96813-5241
Phone
(808) 597-8778
NPI assigned
Mar 17, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 18, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X MD-26808-0 HI Primary

Addresses

Primary practice location

770 Kapiolani Blvd Ste 705
Honolulu, HI 96813-5241

Mailing address

770 Kapiolani Blvd Ste 705
Honolulu, HI 96813-5241

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230707001417 IL Order and Referring Only - Emergency MedicinePractitioner - Emergency Medicine 9931568029

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Columbia University College of Physicians and Surgeons, 2023
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

1001 Kamokila Blvd
Suite 229
Kapolei, HI 96707-9997

1855 W Chicago Ave
Floor 2
Chicago, IL 60622-5513

5841 S Maryland Ave
MC 1052
Chicago, IL 60622

770 Kapiolani Blvd
Suite 705
Honolulu, HI 96813-5212

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
125.081731ILMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
The Emergency Group, Inc. Emergency Medicine Past Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1647475200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1787011200000",
    "number": "1871241885",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "770 KAPIOLANI BLVD STE 705",
            "city": "HONOLULU",
            "state": "HI",
            "postal_code": "968135241"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "770 KAPIOLANI BLVD STE 705",
            "city": "HONOLULU",
            "state": "HI",
            "postal_code": "968135241",
            "telephone_number": "808-597-8778"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIM",
        "first_name": "COURTNEY",
        "middle_name": "MARIKO KAHEALANI",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-03-17",
        "last_updated": "2026-08-18",
        "certification_date": "2026-08-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "HI",
            "license": "MD-26808-0",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Honolulu, HI

Sources for this page

Verify at the official NPI Registry.